If you have Medicare, you have 2 options for receiving hospital treatment: public or private. In the public system, Medicare will generally pay all of your costs.
If you choose private hospital care, your costs can be covered in a few ways. Medicare will still pay some, but a private health fund can also cover some of your fees. If you don't have private health cover, then you'd need to pay for the entire private procedure. If you do have private hospital cover for your treatment, then there may still be out of pocket costs.
The table below compares some costs of common medical procedures in 5 different states. The data comes from Medical Costs Finder, a tool managed by the Department of Health and Aged Care. The data was last updated on 29 September 2023.
| Treatment | % with no out-of-pocket costs | Typical specialists’ fees | Patients typically paid |
|---|---|---|---|
| Adenoid removal | 33% | $1,500 | $810 |
| Ankle replacement | 30% | $5,700 | $1,500 |
| Knee reconstruction | 28% | $4,500 | $2,300 |
| Knee arthroscopy | 45% | $2,500 | $850 |
| Breast biopsy | 41% | $2,200 | $440 |
| Breast reduction | 9% | $11,000 | $8,600 |
| Caesarean section (complex) | 43% | $4,600 | $500 |
| Caesarean section (no complications) | 51% | $3,500 | $500 |
| Cataract surgery | 69% | $2,100 | $500 |
| Colonoscopy | 83% | $1,300 | $250 |
| Dialysis | NA | NA | NA |
| Gastric band | NA | NA | NA |
| Gastric bypass | 44% | $3,900 | $1,100 |
| Gastroscopy | 83% | $960 | $190 |
| Heart-related angiogram | 87% | $1,900 | $60 |
| Heart valve replacement (not TAVI) | 34% | $15,000 | $510 |
| Hip replacement (bilateral) | 22% | $9,900 | $5,500 |
| Hip replacement | 33% | $5,300 | $1,100 |
| Femoral or inguinal hernia repair | 53% | $2,200 | $560 |
| Knee replacement | 38% | $5,200 | $1,100 |
| Laparoscopy | 48% | $2,800 | $540 |
| Male contraception (e.g. vasectomy) | 46% | $1,200 | $510 |
| Total mastectomy (remove breast) | 50% | $3,800 | $520 |
| Pacemaker | 53% | $2,600 | $60 |
| Patella stabilisation (stabilise the kneecap) | 35% | $3,500 | $1,300 |
| Prostatectomy (endoscopic) | 46% | $3,400 | $820 |
| Pterygium surgery | 58% | $1,700 | $250 |
| Removal of skin lesion | 52% | $1,700 | $500 |
| Retinal detachment repair - surgery | 54% | $3,300 | $400 |
| Rotator cuff repair | 32% | $3,900 | $2,000 |
| Septoplasty | 29% | $2,700 | $1,000 |
| Shoulder replacement | 32% | $6,000 | $2,500 |
| Sinus surgery | 39% | $3,400 | $840 |
| Sleep studies | 99% | $730 | $20 |
| Sleeve gastrectomy (partial stomach removal) | 51% | $3,200 | $880 |
| Stress incontinence | 45% | $3,000 | $1,500 |
| Tonsillectomy with or without adenoidectomy (12 years of age and over) | 30% | $2,100 | $1,300 |
| Turbinectomy (remove small nasal bones) | 24% | $1,800 | $860 |
| Umbilical hernia repair | 57% | $1,700 | $590 |
| Vaginal delivery (no complications) | 70% | $2,900 | $500 |
| Vaginal delivery (complex) | 61% | $3,600 | $500 |
| Vaginal repair | 49% | $3,300 | $680 |
| Varicose veins | 53% | $1,900 | $400 |
| Wound debridement | 66% | $1,700 | $380 |
| Treatment | % with no out-of-pocket costs | Typical specialists’ fees | Patients typically paid |
|---|---|---|---|
| Adenoid removal | 20% | $1,100 | $400 |
| Ankle replacement | 17% | $4,400 | $560 |
| Knee reconstruction | 16% | $3,800 | $570 |
| Knee arthroscopy | 26% | $2,100 | $390 |
| Breast biopsy | 20% | $2,100 | $280 |
| Breast reduction | 12% | $9,400 | $7,200 |
| Caesarean section (complex) | 38% | $4,400 | $450 |
| Caesarean section (no complications) | 35% | $3,400 | $400 |
| Cataract surgery | 30% | $1,900 | $300 |
| Colonoscopy | 79% | $1,100 | $130 |
| Dialysis | NA | NA | NA |
| Gastric band | 28% | $3,100 | $500 |
| Gastric bypass | 21% | $4,800 | $1,100 |
| Gastroscopy | 79% | $910 | $130 |
| Heart-related angiogram | 85% | $2,000 | $110 |
| Heart valve replacement (not TAVI) | 27% | $13,000 | $470 |
| Hip replacement (bilateral) | 8% | $10,000 | $5,500 |
| Hip replacement | 18% | $5,500 | $730 |
| Femoral or inguinal hernia repair | 34% | $1,800 | $280 |
| Knee replacement | 20% | $5,100 | $600 |
| Laparoscopy | 29% | $2,500 | $380 |
| Male contraception (e.g. vasectomy) | 33% | $980 | $200 |
| Total mastectomy (remove breast) | 23% | $4,200 | $500 |
| Pacemaker | 51% | $2,300 | $50 |
| Patella stabilisation (stabilise the kneecap) | 17% | $3,200 | $520 |
| Prostatectomy (endoscopic) | 32% | $2,900 | $400 |
| Pterygium surgery | 21% | $1,700 | $270 |
| Removal of skin lesion | 70% | $1,500 | $250 |
| Retinal detachment repair - surgery | 13% | $3,500 | $250 |
| Rotator cuff repair | 22% | $3,300 | $520 |
| Septoplasty | 20% | $2,400 | $580 |
| Shoulder replacement | 21% | $5,700 | $620 |
| Sinus surgery | 27% | $2,800 | $450 |
| Sleep studies | 96% | $730 | $10 |
| Sleeve gastrectomy (partial stomach removal) | 35% | $3,500 | $540 |
| Stress incontinence | 29% | $2,300 | $260 |
| Tonsillectomy with or without adenoidectomy (12 years of age and over) | 21% | $1,600 | $500 |
| Turbinectomy (remove small nasal bones) | 20% | $1,400 | $480 |
| Umbilical hernia repair | 37% | $1,400 | $270 |
| Vaginal delivery (no complications) | 69% | $2,800 | $350 |
| Vaginal delivery (complex) | 45% | $4,300 | $430 |
| Vaginal repair | 25% | $3,200 | $420 |
| Varicose veins | 33% | $2,100 | $300 |
| Wound debridement | 53% | $1,600 | $200 |
| Treatment | % with no out-of-pocket costs | Typical specialists’ fees | Patients typically paid |
|---|---|---|---|
| Adenoid removal | 23% | $1,300 | $400 |
| Ankle replacement | 13% | $4,500 | $5,700 |
| Knee reconstruction | 19% | $4,100 | $1,000 |
| Knee arthroscopy | 25% | $2,300 | $650 |
| Breast biopsy | 22% | $2,500 | $700 |
| Breast reduction | 7% | $9,800 | $7,800 |
| Caesarean section (complex) | 46% | $4,800 | $500 |
| Caesarean section (no complications) | 41% | $3,600 | $500 |
| Cataract surgery | 40% | $2,100 | $450 |
| Colonoscopy | 80% | $1,200 | $130 |
| Dialysis | 99% | $80 | $0 |
| Gastric band | NA | NA | NA |
| Gastric bypass | 19% | $3,500 | $500 |
| Gastroscopy | 80% | $960 | $100 |
| Heart-related angiogram | 64% | $2,000 | $10 |
| Heart valve replacement (not TAVI) | 32% | $16,000 | $480 |
| Hip replacement (bilateral) | 16% | $8,400 | $2,400 |
| Hip replacement | 19% | $5,000 | $1,000 |
| Femoral or inguinal hernia repair | 28% | $2,100 | $500 |
| Knee replacement | 22% | $4,800 | $990 |
| Laparoscopy | 24% | $2,800 | $690 |
| Male contraception (e.g. vasectomy) | 40% | $1,200 | $440 |
| Total mastectomy (remove breast) | 21% | $4,200 | $800 |
| Pacemaker | 42% | $2,700 | $40 |
| Patella stabilisation (stabilise the kneecap) | 22% | $3,300 | $900 |
| Prostatectomy (endoscopic) | 26% | $3,300 | $580 |
| Pterygium surgery | 24% | $1,800 | $450 |
| Removal of skin lesion | 35% | $1,800 | $500 |
| Retinal detachment repair - surgery | 40% | $4,000 | $630 |
| Rotator cuff repair | 21% | $3,400 | $890 |
| Septoplasty | 23% | $2,500 | $690 |
| Shoulder replacement | 16% | $5,400 | $1,000 |
| Sinus surgery | 25% | $3,200 | $760 |
| Sleep studies | 99% | $730 | $10 |
| Sleeve gastrectomy (partial stomach removal) | 17% | $3,000 | $850 |
| Stress incontinence | 16% | $2,600 | $680 |
| Tonsillectomy with or without adenoidectomy (12 years of age and over) | 22% | $1,700 | $570 |
| Turbinectomy (remove small nasal bones) | 26% | $1,500 | $540 |
| Umbilical hernia repair | 29% | $1,700 | $500 |
| Vaginal delivery (no complications) | 78% | $2,900 | $300 |
| Vaginal delivery (complex) | 55% | $3,700 | $450 |
| Vaginal repair | 30% | $3,300 | $690 |
| Varicose veins | 17% | $2,300 | $880 |
| Wound debridement | 37% | $1,800 | $500 |
| Treatment | % with no out-of-pocket costs | Typical specialists’ fees | Patients typically paid |
|---|---|---|---|
| Adenoid removal | 44% | $1,000 | $270 |
| Ankle replacement | NA | NA | NA |
| Knee reconstruction | 19% | $3,500 | $280 |
| Knee arthroscopy | 27% | $1,900 | $190 |
| Breast biopsy | 54% | $2,300 | $150 |
| Breast reduction | 9% | $5,600 | $3,600 |
| Caesarean section (complex) | 25% | $5,000 | $300 |
| Caesarean section (no complications) | 23% | $3,400 | $250 |
| Cataract surgery | 49% | $1,900 | $300 |
| Colonoscopy | 90% | $1,200 | $120 |
| Dialysis | NA | NA | NA |
| Gastric band | NA | NA | NA |
| Gastric bypass | 12% | $4,200 | $500 |
| Gastroscopy | 91% | $930 | $100 |
| Heart-related angiogram | 92% | $2,100 | $10 |
| Heart valve replacement (not TAVI) | 50% | $12,000 | $300 |
| Hip replacement (bilateral) | NA | NA | NA |
| Hip replacement | 28% | $4,700 | $350 |
| Femoral or inguinal hernia repair | 43% | $1,600 | $200 |
| Knee replacement | 30% | $4,600 | $350 |
| Laparoscopy | 20% | $2,600 | $320 |
| Male contraception (e.g. vasectomy) | 38% | $880 | $150 |
| Total mastectomy (remove breast) | 56% | $4,000 | $210 |
| Pacemaker | 55% | $2,600 | $40 |
| Patella stabilisation (stabilise the kneecap) | 21% | $2,700 | $240 |
| Prostatectomy (endoscopic) | 47% | $2,700 | $220 |
| Pterygium surgery | 55% | $1,900 | $500 |
| Removal of skin lesion | 62% | $1,400 | $250 |
| Retinal detachment repair - surgery | NA | NA | NA |
| Rotator cuff repair | 30% | $2,800 | $250 |
| Septoplasty | 18% | $2,200 | $530 |
| Shoulder replacement | 38% | $4,800 | $300 |
| Sinus surgery | 25% | $3,100 | $500 |
| Sleep studies | NA | NA | NA |
| Sleeve gastrectomy (partial stomach removal) | 15% | $3,500 | $500 |
| Stress incontinence | 14% | $2,300 | $500 |
| Tonsillectomy with or without adenoidectomy (12 years of age and over) | 19% | $1,500 | $430 |
| Turbinectomy (remove small nasal bones) | 30% | $1,400 | $400 |
| Umbilical hernia repair | 32% | $1,300 | $150 |
| Vaginal delivery (no complications) | 56% | $2,900 | $250 |
| Vaginal delivery (complex) | 45% | $3,100 | $200 |
| Vaginal repair | 39% | $2,800 | $350 |
| Varicose veins | 21% | $1,600 | $160 |
| Wound debridement | 66% | $1,500 | $160 |
| Treatment | % with no out-of-pocket costs | Typical specialists’ fees | Patients typically paid |
|---|---|---|---|
| Adenoid removal | 49% | $1,200 | $510 |
| Ankle replacement | NA | NA | NA |
| Knee reconstruction | 47% | $3,500 | $470 |
| Knee arthroscopy | 57% | $2,000 | $450 |
| Breast biopsy | 22% | $2,700 | $560 |
| Breast reduction | 6% | $8,800 | $6,900 |
| Caesarean section (complex) | 72% | $4,900 | $440 |
| Caesarean section (no complications) | 76% | $3,400 | $280 |
| Cataract surgery | 85% | $1,700 | $110 |
| Colonoscopy | 95% | $1,100 | $110 |
| Dialysis | NA | NA | NA |
| Gastric band | NA | NA | NA |
| Gastric bypass | 76% | $3,800 | $500 |
| Gastroscopy | 94% | $850 | $130 |
| Heart-related angiogram | 92% | $2,000 | $20 |
| Heart valve replacement (not TAVI) | 26% | $16,000 | $350 |
| Hip replacement (bilateral) | NA | NA | NA |
| Hip replacement | 55% | $4,200 | $450 |
| Femoral or inguinal hernia repair | 69% | $1,800 | $300 |
| Knee replacement | 55% | $4,000 | $350 |
| Laparoscopy | 56% | $2,600 | $360 |
| Male contraception (e.g. vasectomy) | 53% | $1,100 | $470 |
| Total mastectomy (remove breast) | 26% | $3,600 | $500 |
| Pacemaker | 62% | $2,000 | $50 |
| Patella stabilisation (stabilise the kneecap) | 47% | $2,800 | $350 |
| Prostatectomy (endoscopic) | 49% | $2,800 | $720 |
| Pterygium surgery | 75% | $1,500 | $210 |
| Removal of skin lesion | 54% | $1,500 | $260 |
| Retinal detachment repair - surgery | NA | NA | NA |
| Rotator cuff repair | 58% | $2,800 | $440 |
| Septoplasty | 21% | $2,700 | $510 |
| Shoulder replacement | 62% | $4,400 | $300 |
| Sinus surgery | 31% | $2,800 | $500 |
| Sleep studies | 99% | $760 | $70 |
| Sleeve gastrectomy (partial stomach removal) | 35% | $6,300 | $4,000 |
| Stress incontinence | 31% | $2,400 | $1,200 |
| Tonsillectomy with or without adenoidectomy (12 years of age and over) | 25% | $1,500 | $550 |
| Turbinectomy (remove small nasal bones) | 27% | $1,500 | $530 |
| Umbilical hernia repair | 69% | $1,500 | $220 |
| Vaginal delivery (no complications) | 83% | $2,700 | $190 |
| Vaginal delivery (complex) | NA | NA | NA |
| Vaginal repair | 56% | $3,300 | $870 |
| Varicose veins | 64% | $1,600 | $40 |
| Wound debridement | 61% | $1,700 | $460 |
| Response | 75+ yrs | 65-74 yrs | 55-64 yrs | 45-54 yrs | 35-44 yrs | 25-34 yrs | 18-24 yrs |
|---|---|---|---|---|---|---|---|
| No | 61.36% | 50.58% | 50.93% | 40.24% | 36.76% | 47.89% | 43.53% |
| Yes | 25% | 32.56% | 35.4% | 40.24% | 43.24% | 34.74% | 44.71% |
| Somewhat | 13.64% | 16.86% | 13.66% | 19.53% | 20% | 17.37% | 11.76% |
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